CMS Price Transparency Data

Blood test, sodium

Facility: Hospital of Univ of Pennsylvania

Billing Code: 84295 (CPT)

Factual Cost Summary (Answer Capsule)
  • CPT Billing Code: 84295
  • Insurance Median: $31
  • Cash Discount Price: $170
  • vs. Medicare Baseline: 6.44x Medicare
The contracted insurance negotiated median rate for a Blood test, sodium at Hospital of Univ of Pennsylvania is $31. If you are paying out-of-pocket or uninsured, the self-pay cash discount rate is $170. Compared to the federal Medicare reimbursement reference rate of $4.81, this hospital’s rate is 6.44x the Medicare baseline. Located in 3400 Spruce St, Philadelphia, PA.
Cash / Self-Pay
$170

Average discount available for prompt cash payment at this facility.

Insurance Median
$31

Median negotiated contract rate across all mapped commercial carriers.

Medicare Reference Rate
$4.81

Standard federal government reimbursement rate for this code.

Visual Cost Comparison vs. Medicare

Medicare Reference Baseline: $4.81 (100%)
Cash / Self-Pay: $170 (3534%)
Insurance Median: $31 (644%)
Cash: $170 (3534% of Medicare)
Ins. Median: $31 (644% of Medicare)

Understanding this gauge: We use the federal Medicare rate of $4.81 as the cost baseline. Rates below the baseline represent excellent value. In-network commercial rates commonly hover around 150% - 250% of Medicare, while rates exceeding 300% are elevated. Hover over the green and blue markers to view detailed calculations.

Elevated Commercial Rate Alert (Value-Gap)

The negotiated rate at this facility is 644% of the Medicare baseline (a markup of 544%). Patients with high-deductible plans or out-of-network benefits may face excessive out-of-pocket costs.

Out-of-Pocket Cost Estimator

Estimate whether it is more economical to use your insurance or pay the upfront self-pay cash rate.

Input your details and click calculate to compare out-of-pocket costs.

Commercial Insurance Negotiated Rates

Negotiated contract ranges established by major commercial carriers at this facility.

Carrier / Plan Group Contract Rate Range vs. Medicare Reference
Blue Cross Blue Shield $2 - $29 42%
Gspp And Wissahickon Hospice $2 42%
Ibc Commercial Hpn $2 42%
Keystone Hmo Proactive $2 42%
Cigna $3 - $76 62%
UnitedHealthcare $4 - $170 83%
Aetna $5 - $170 104%
Clover Health Plan $5 104%
Devoted Health $5 104%
Geisinger Health Plan $5 - $15 104%
Health Partners $5 - $170 104%
Humana $5 - $136 104%
Ibc $5 104%
Kaiser Permanente $5 - $170 104%
Keystone First $5 104%
Medicare (plans) $5 104%
Pa Health And Wellness $5 - $8 104%
Penn Life (Living Independently For Elders) $5 104%
Philadelphia Va Medical Center $5 104%
Tricare $5 104%
Upmc $5 - $170 104%
Us Family Health Plan $5 104%
Gateway Health Plan $6 125%
Medicaid / KanCare $6 - $170 125%
Pa Medical Assistance $6 - $170 125%
Elap $7 146%
Claims Watcher $8 - $9 166%
Keystone Mercy Health Plan $8 - $170 166%
Oscar Health Plan $8 166%
Centivo $9 187%
Elap Services $9 187%
Highmark $10 208%
Penn Global Medicine $13 270%
Paired Kidney Exchange $14 291%
Horizon Nj Health $29 - $30 603%
Preferred Health Care Eliance $37 769%
Pgm - Regie De L'Assurance Maladie Quebec $39 811%
Pgm - Kuwait Defense $60 - $76 1247%
Qualcare $65 1351%
Olympus $67 1393%
Coventry $68 - $87 1414%
Pgm - Chop $68 1414%
Wissahickon Hospice $68 1414%
Healthamerica/Coventry $76 - $83 1580%
First Health Global $85 1767%
Health Net $102 2121%
Pgm - Royal Embassy Of Saudi Arabia $102 2121%
Pgm - Embassy Of Qatar $110 2287%
Pgm - Ontario Ministry Of Health And Long-Term Care (Ohip) $110 2287%
Interlink $114 2370%
Pgm - Embassy Of The United Emirates/Ipc $119 2474%
Health America/Ccn $136 2827%
Intergroup $136 2827%
Pgm - Kuwait Health Division $136 2827%
Pgm - Kuwait Oil $136 2827%
Preferred Care $136 2827%
Blue Quality Centers For Transplant (Bqct) $170 3534%
City Of Philadelphia Behavioral Health $170 3534%
Commercial Other $170 3534%
International Pfs $170 3534%
United Behavioral Health $170 3534%
Workers Compensation $170 3534%

Self-Pay Upfront Cash Action Plan

Insurance In-Network Protection Plan

Facility Profile & Credentials

  • Address: 3400 Spruce St, Philadelphia, PA 19104
  • CMS Rating: ★★★★★
  • Ownership Type: Voluntary non-profit - Private
  • Hospital Type: Acute Care Hospitals